Normal Newborn
The unexplained death of a seemingly healthy baby, usually during sleep?
Discuss education given to parents for prevention.
SIDS
Infants should sleep on their backs in a crib or bassinet with a tight-fitting sheet. Nothing in the crib, such as stuffed animals, crib bumpers, loose blankets, or pillows. Circulating air in the room by fan and using a pacifier decreases the risk, and avoiding secondhand smoke decreases it by 50%. Room sharing NOT bed sharing!
When is the postpartum period?
The time after childbirth when a woman’s body returns to its pre-pregnancy state. From the delivery of the placenta to six weeks.
What are risk factors for having a hemorrhage?
4 T’s”: Tone, Trauma, Tissue, Thrombin. Prolonged labor or rapid (precipitous) labor, High parity (many previous births), Use of magnesium sulfate, General anesthesia, Operative delivery (forceps, vacuum), Cesarean section, Uterine rupture or inversion, Retained placental fragments, Abnormal placentation (e.g., accreta), Coagulation disorders, Severe preeclampsia/HELLP, Anticoagulant use, Prior history of PPH, Infection, Maternal obesity, Induction or augmentation of labor (Pitocin)
what meds are given at delivery
Erythromycin ointment in the eyes
Vit K
Hep B
painful overfilling and swelling of the breasts due to increased milk, blood, and fluid—most commonly occurring in the early days after childbirth when milk “comes in.”
Breast Engorgement?
Heat loss that occurs when an infant’s body comes into direct contact with a cooler surface.
Examples: Placing a baby on a cold scale or mattress, Touching cold hands or objects, Lying on a cold examination table. The baby’s heat transfers directly to the cooler object.
Conduction
Postpartum depression
§ Time Frame
§ What are some things you expect to see from mom?
Usually begins within 2–8 weeks after delivery but Can occur anytime in the first 12 months postpartum. Distinguishing factor: Lasts >2 weeks
Persistent sadness, Crying spells, Hopelessness or feeling overwhelmed, Irritability or anger, Feeling like a bad mother, Difficulty concentrating, Indecisiveness, Loss of interest in activities (anhedonia), Possible intrusive thoughts (e.g., fear of harming baby or self), Sleep disturbances, Appetite changes (↑ or ↓), Difficulty bonding with baby, Withdrawal from family/friends, Less interest in caring for the newborn
Which hemorrhage medication cannot be given in a patient with a history of asthma
Hemabate
normal neurologic reflex in infants where the toes respond in a specific way when the sole of the foot is stimulated.
Stroke the lateral sole of the foot (heel → up toward toes)
Babinski Reflex
· Define Meconium:
o When should it pass?
first s tool of a newborn, composed of:Intestinal epithelial cells, Amniotic fluid, Bile, Mucus
It is thick, sticky, and dark green to black in color.
should pass within the first 24 hours after birth
Heat loss that occurs when cool air moves around the infant, carrying heat away from the body. Examples: Drafts from open windows or doors, Air conditioning or fans blowing on the baby, Frequent opening of incubator doors
The moving air pulls heat away from the baby’s skin
Convection
Where is the fundus found 6-12 hours after delivery?
At the level of the umbilicus (belly button) or slightly above it
What is uterine atony?
· What are your assessment findings?
· Discuss treatment:
o 1st action:
o 1st medication:
Uterine atony is the failure of the uterus to contract effectively after delivery, leading to continued bleeding from the placental site. It is the most common cause of Postpartum Hemorrhage. Boggy, soft uterus (instead of firm), Fundus may be above expected level, Heavy vaginal bleeding (may see clots), Uterus may be displaced (often to the right if bladder is full)
first action: fundal assage
First med: pitocin
condition seen in newborns—especially premature infants—caused by lack of surfactant, leading to alveolar collapse and difficulty breathing.
Usually appear immediately or within a few hours after birth: Tachypnea (>60 breaths/min), Grunting, Nasal flaring, Retractions, Cyanosis, Decreased oxygen saturation
RDS
a common, temporary yellowing of a newborn’s skin and eyes due to normal breakdown of fetal red blood cells and the immature liver’s inability to process bilirubin quickly.
Physiological Jaundice
It happens when a newborn has extra fluid in the lungs that hasn’t been cleared yet after delivery. This makes breathing faster and a bit harder. Typically within the first 1–2 hours after birth and Symptoms usually resolve within 24–72 hours
TTN
Infection + inflammation of the breast, usually from blocked milk ducts or bacteria entering through cracked nipples
Mastitis
Retained placental tissue/fragments
· Assessment findings:
· Medical/Nursing management:
Retention of pieces of the placenta in the uterus after delivery, preventing proper uterine contraction and leading to bleeding. A cause of Postpartum Hemorrhage (the “Tissue” in the 4 T’s). Persistent vaginal bleeding, Uterus Boggy or firm but still bleeding, Fundus may not descend, Large clots, Possible foul-smelling lochia (if infection develops),
Assess fundus (tone, position), Fundal massage if boggy, Monitor vital signs & bleeding closely, Call provider, Maintain IV access, Prepare for procedures (manual removal or D&C), Provide emotional support
A newborn is assessed at 1 minute after birth:
Heart rate: 120 bpm
Respirations: Slow, irregular cry
Muscle tone: Some flexion of arms and legs
Reflex irritability: Grimaces when stimulated
Color: Body pink, hands and feet blue
APGAR 6/10
congenital condition where a baby is born with extra fingers or toes. It can occur on one or both hands/feet and may be fully formed or just a small skin tag.
Polydactyly
Tell me about the three fetal shunts?
Ductus Venosus: Bypasses the liver, connects the umbilical vein to inferior vena cava
Ductus Arteriosis: Bypasses the lungs, connects pulmonary artery to the aorta
Foramen Ovale: bypasses the lungs by connecting the right atrium to the left
First 24–48 hours postpartum
This is a passive, dependent phase where the mother is focused on herself and her experience.
Rubins Theory-Taking in phase
rare but life-threatening condition in which the uterus turns inside out, usually after delivery of the placenta.
Uterine Inversion
two maneuvers to test for hip displasia
Barlow Maneuver
Ortolani Maneuver
excessive or abnormal yellowing of a newborn’s skin and eyes, caused by underlying disease or abnormal bilirubin metabolism, and requires prompt evaluation and treatment.
Pathologic Jaundice